哈尔滨市社区居民精神卫生知识认知及对患者态度的调查及影响因素分析

Awareness of mental health-related knowledge and attitude towards patients with mental disorders among community residents in Harbin City and the influencing factors

目的 了解哈尔滨市社区居民精神卫生知识的知晓情况及对精神疾病患者的态度,分析其影响因素,为进一步制定有针对性的策略提供科学依据。方法 2013年10-12月间采取分阶段抽样方法,随机抽取社区医生、患者家属及普通居民共计720人,就精神卫生知识和对精神疾病患者态度进行问卷调查,比较人群及居住地差异,并分析影响因素。结果 回收有效问卷702份,有效回收率为97.50%;702名社区居民精神卫生知识的总知晓率为73.44%,社区医生知晓率（85.25%）显著高于患者家属（75.03%）和普通居民（72.34%）（P〈0.05）,城市居民（74.55%）高于城郊与乡镇居民（70.40%）（P〈0.05）;社区居民态度问卷的总得分为（34.26±5.84）,不同年龄社区居民态度问卷总得分总体比较差异有统计学意义（P〈0.05）,表现为老年人显著低于中年人和青年人（P〈0.05）。563名（78.77%）社区居民对精神疾病患者的态度有较好或包容的程度,城郊及乡镇居民对精神疾病患者态度的包容程度好于城市居民（P〈0.05）。社区居民精神卫生知识的认知程度与对精神疾病患者的态度不存在相关关系（秩相关分析,rs=-0.01420,P=0.7078）,在社区居民精神卫生知识认知情况的多因素Logsitic回归模型显示社区医生（OR=2.654,95%CI：1.082~6.508）、对精神疾病患者知悉者（OR=1.956,95%CI：1.373~2.787）、文化程度大专及以上学历者（OR=2.968,95%CI：2.176~4.049）对精神卫生知识的认知程度更好。在社区居民对精神疾病患者态度包容程度的多因素Logsitic回归模型中表现为老年人（OR=0.571,95%CI：0.363~0.900）的态度相对消极,对宣传教育满意者（OR=1.460,95%CI：1.093~1.951）、城郊及乡镇居民（OR=1.383,95%CI：1.008~1.896）的态度较为包容。结论 2013年底哈尔滨市社区居民精神卫生知识的总知晓率与国家精神卫生规划2015年的既定要求（即实现2015年知晓率80%的工作目标）还有一段差距。大部分社区居民对精神卫生的知识有较好或好的认知,社区居民对精神疾病患者的态度较好。文化程度、对患者的知悉情况、人群类别是精神卫生知识认知程度的影响因素,宣传教育的满意情况、年龄、居住地区是影响对精神疾病患者态度的因素。

Objective To investigate the awareness of mental health - related knowledge and attitude towards patients with mental disorders in Harbin community residents, to analyze their influencing factors so as to provide scientific evidence for further formulating the targeted strategies. Methods A total of 720 residents including community doctors, patients＇ relatives and common residents were randomly selected based on a multistage sampling method from October to December 2013. A question- naire survey on awareness of mental health - related knowledge and attitude towards mental disorders was conducted among the residents. The differences in populations from different regions were compared; meanwhile, the influencing factors were ana- lyzed. Results A total of 702 valid questionnaires were returned, with an effective recovery rate of 97.50 %. The total awareness rate of mental health - related knowledge in the respondents was 73.44 %, and the awareness rate was significantly higher in the community doctors （85.25%） than in the patients＇ relatives （75.03%） and the common residents （72.34%） as well as higher in the urban residents （74.55%） than in the suburban and rural residents （70.40%） （both P〈0.05）. The total score of the respondents＇ attitude towards mental disorders was （34.26 ±5.84）, and the score was significantly lower in the old - aged respondents than in the middle - aged and young respondents （P〈0.05）. 563 （78.77%） respondents had a better atti- tude or degree of tolerance to patients with mental disorders, and the degree of tolerance for the patients in suburban and rural residents was better than that in urban residents （ P 〈 0.05）. There was no correlation between the awareness of mental health - related knowledge and attitude towards patients with mental disorders in the community residents （Spearman correlation analysis,rs = -0. 01420, P = 0. 7078）. Multivariate Logistic regression analysis showed that community doctors （OR = 2. 654, 95 % CI ： 1. 082 - 6. 508）, the residents with awareness of mental disorder patients （ OR = 1. 956, 95 % CI ： 1. 373 - 2. 787） and the residents with college degree or above （ OR = 2. 968, 95 % CI ： 2. 176 - 4. 049） had fair knowledge about mental disorders. Mult- ivariate Logistic regression analysis showed that the senile had a relatively negative attitude （OR = 0. 571, 95% CI.O. 363 - 0. 900）, and the residents who were satisfied with the publicity and education （OR = 1. 460, 95% CI. 1. 093 - 1. 951 ） and the suburban and rural residents （ OR = 1. 383, 95 % CI ： 1. 008 - 1. 896） had a tolerant attitude towards patients with mental disor- ders. Conclusions The total awareness rate of mental health - related knowledge in the community residents in Harbin City has not yet met the demands of the 2015 National Mental Health Plan （namely achieving an awareness rate of 80% by 2015）. Most of the community residents have better or good cognition concerning mental health - related knowledge as well as good atti- tudes towards patients with mental disorders. Educational background, familiarity with the patients and population category are the factors influencing the awareness of mental health-related knowledge, while satisfaction about publicity and education, age and residential district are the factors influencing attitude towards patients with mental disorders.